Comprehensive Review of Dry Socket: Etiology, Risk Factors, Prevention, and Management

Abstract

Dry socket, or alveolar osteitis, is a common complication following tooth extraction, characterized by partial or complete loss of the blood clot within the extraction site. It typically presents with intense pain, exposed alveolar bone, necrotic tissue, and unpleasant odor. The exact mechanism remains poorly understood, but increased fibrinolytic activity due to various factors is thought to play a role. Incidence ranges from 1% to 5% for all extractions, reaching up to 38% for mandibular third molars. Surgical trauma, complexity of the procedure, operator experience, smoking, oral contraceptives, and bacterial infection are among the major risk factors. Prevention strategies include the use of chlorhexidine, antibiotics, antifibrinolytics, antimicrobial photodynamic therapy, and low-level laser therapy. Management involves irrigation, medicated dressings, analgesics, and, in some cases, surgical intervention. Understanding the etiology, risk factors, and preventive measures is crucial for reducing the incidence of dry socket and improving patient outcomes. Further research is needed to elucidate the precise pathophysiology and develop more effective prevention and treatment strategies for this painful postoperative complication.